Causes

A pilonidal cyst may be congenital or acquired. If congenital, it probably began as a defect that existed at birth. Sometime later, the defect allowed an infection to develop. If acquired, it may be the enlargement of a simple hair follicle infection or the result of a hair penetrating the skin and causing an infection.

Risk Factors

The following factors increase your chance of developing a pilonidal cyst:

Personal or family history of pilonidal disease

Large amounts of hair in the region

Midline skin pits
or deep gluteal cleft

Tailbone irritation or injury

Continuous bouncing in seated position, such as horseback riding or cycling

Symptoms

Painful swelling over your sacrum, which is the area just above your tailbone

A foul smell or pus draining from that area

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a surgeon for treatment. There are no diagnostic tests required.

Treatment

Talk with your doctor about the best treatment plan for you. The choice of treatment will depend on the extent of the condition and your general overall health. Treatment options include:

Home Treatment

As with all localized infections under the skin, warm water soaks will draw out the infection. This will not completely cure the condition, but it will help.

Incision and Drainage

The abscess is lanced, the pus drained, and the wound is packed with sterile gauze. This helps it heal from the inside out. This usually does not cure the problem because abnormal tissue remains.

Excision

To completely cure the condition, all affected tissue needs to be removed. It may be considered if you have repeated infections. This is a more extensive surgical procedure than simple incision and drainage. The surgical wound may be closed with sutures or left open to heal from the inside.

Prevention

To help reduce your chances of a pilonidal abscess:

Keep the area clean and dry

Avoid sitting for a long time on hard surfaces

Remove hair from the area

Talk to your doctor about laser hair removal

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.